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1.
Indian J Pediatr ; 2009 Nov; 76(11): 1169-1172
Artigo em Inglês | IMSEAR | ID: sea-142433

RESUMO

We report a 2 month male child presenting with diabetic ketoacidosis (DKA) and seizures treated with intravenous fluids and intravenous insulin infusion till the ketoacidosis was reversed, thereafter responding well to sulphonylureas and at age of 13 months going into complete remission. At age of 11 mo developmental delay in the form of negative neck holding and inability to sit without support was seen. The child is 3 yr of age now ,euglycemic without any insulin or oral hypoglycemic agents but has severe developmental delay. Genetic analysis was negative for mutations of KCNJ11, 6q24, Glucokinase and IPF-1 genes. A mutation R1183W was found in the ABCC8 gene encoding SUR1, which was the cause of neonatal diabetes in this case.


Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Cromossomos Humanos Par 6/genética , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/genética , Cetoacidose Diabética/tratamento farmacológico , Cetoacidose Diabética/genética , Humanos , Hipoglicemiantes/uso terapêutico , Lactente , Insulina/uso terapêutico , Masculino , Mutação Puntual/genética , Canais de Potássio Corretores do Fluxo de Internalização/genética , Receptores de Droga/genética , Compostos de Sulfonilureia/uso terapêutico
2.
Indian J Pediatr ; 2007 Jan; 74(1): 39-42
Artigo em Inglês | IMSEAR | ID: sea-82027

RESUMO

OBJECTIVE: To study the epidemiological pattern, clinical picture, the recent trends of multidrug-resistant typhoid fever (MDRTF), and therapeutic response of ofloxacin and ceftriaxone in MDRTF. METHODS: The present prospective randomized controlled parallel study was conducted on 93 blood culture-proven Salmonella typhi children. All MDRTF cases were randomized to treatment with ofloxacin or ceftriaxone. RESULTS: Of 93 children, 62 (66.6%) were MDRTF. 24 cases were below 5 years, 26 between 5-10 years and 12 were above 10 years. Male to female ratio was 1.85: 1. Majority of cases came from lower middle socio-economic classes with poor personal hygiene. Fever was the main presenting symptom. Hepatomegaly and splenomegaly was present in 88% and 46% cases respectively. 19 (30.6%) cases developed complications. Mean defervescence time with ceftriaxone and ofloxacin was 4.258 and 4.968 days respectively. CONCLUSION: MDRTF is still emerging as serious public and therapeutic challenge. Ceftriaxone is well-tolerated and effective drug but expensive whereas ofloxacin is safe, cost-effective and therapeutic alternative in treatment of MDRTF in children with comparable efficacy to ceftriaxone.


Assuntos
Administração Oral , Sangue/microbiologia , Ceftriaxona/administração & dosagem , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Índia , Lactente , Infusões Intravenosas , Masculino , Testes de Sensibilidade Microbiana , Ofloxacino/administração & dosagem , Probabilidade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Salmonella typhi/efeitos dos fármacos , Índice de Gravidade de Doença , Taxa de Sobrevida , Resultado do Tratamento , Febre Tifoide/diagnóstico
3.
Indian J Pediatr ; 2005 Jul; 72(7): 631-3
Artigo em Inglês | IMSEAR | ID: sea-82860

RESUMO

We report a case of congenital tuberculosis diagnosed by liver biopsy in a 8-week-old infant presented with acute abdomen. Liver biopsy showed multiple lymphoepitheloid cell granulomas with Langhans' giant cells and central necrosis. The culture of caseous material from the liver showed Mycobacterium tuberculosis . Antituberculous treatment was started. Endometrial biopsy in the asymptomatic mother confirmed the source of infection.


Assuntos
Feminino , Humanos , Lactente , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Gravidez , Complicações Infecciosas na Gravidez , Tuberculose dos Genitais Femininos/complicações , Tuberculose Hepática/congênito
4.
Indian J Pediatr ; 2004 Jul; 71(7): 601-5
Artigo em Inglês | IMSEAR | ID: sea-82246

RESUMO

OBJECTIVE: The emergence of penicillin resistant strains and the presence of co-pathogens have made the treatment of bacterial infections in children a challenge. Streptococcal tonsillopharyngitis, which is a common infection has been well treated with cefprozil, a novel third generation cephalosporin. The aim of the present study was to evaluate cefprozil in pediatric tonsillopharyngitis. An assessment of the clinical cure and bacteriological eradication rates and an overall tolerability was made. METHODS: It was a prospective, open, non-comparative multicentric study. 316 children (mean age 6.61 years) with tonsillopharyngitis were included. Patients were given cefprozil susp 15 mg/kg/day in two divided doses a day for 10 days. RESULTS: A clinical cure of 96.6% and bacteriological eradication of 94.29% was achieved with cefprozil. Overall tolerability of cefprozil was assessed by physicians and 46% rated tolerability of cefprozil as excellent, 38% as very good, 10% as good, 6% as fair and none as poor. CONCLUSION: Cefprozil has been found to be an excellent drug of superior microbiological and clinical activity in the treatment of pediatric patients with tonsillopharyngitis. The drug also has an expanded spectrum.


Assuntos
Antibacterianos/efeitos adversos , Cefalosporinas/efeitos adversos , Criança , Pré-Escolar , Humanos , Lactente , Faringite/tratamento farmacológico , Estudos Prospectivos , Segurança , Tonsilite/tratamento farmacológico
5.
Indian J Pediatr ; 2004 Apr; 71(4): 319-24
Artigo em Inglês | IMSEAR | ID: sea-81904

RESUMO

Young children contract as many as six to eight upper respiratory tract viral infections per year, and these infections frequently lead to secondary bacterial infections such as acute otitis media and sinusitis. Cefprozil is an orally active third generation cephalosporin which has demonstrated activity against the gram-positive organisms Streptococcus pyogenes, pneumoniae and agalactiae and against methicilin-susceptible Staphylococcus aureus. Cefprozil is also active against various gram-ves and certain anaerobic organisms, and is stable to hydrolysis by a number of b-lactamases. Present study is an effort to study the efficacy and safety of cefprozil in children with acute otitis media. Three hundred and thirty four children aged 6 months through 12 years with clinical symptoms and tympanic membrane signs of AOM received cefprozil 30 mg/kg/day in two divided doses per day for 10 days. Clinically, 96.6% patients were cured, 2.4% improved and there was failure of therapy in 1% of the patients. There was no need for any rescue medication and any change in antibiotic in any patient. A satisfactory bacteriological outcome was (i.e. cure, presumed cure, and cure plus reinfection with a different pathogen) was achieved in 95% of patients. In conclusion, cefprozil is a well tolerated and effective drug for acute otitis media in children. Moreover, its expanded spectrum of activity, ability to achieve adequate concentrations in tissues, suitability for twice-daily dosing, and proven tolerability suggest that it is a better alternative to agents conventionally used in acute otitis media.


Assuntos
Doença Aguda , Antibacterianos/administração & dosagem , Cefalosporinas/administração & dosagem , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Otite Média/tratamento farmacológico , Estudos Prospectivos , Resultado do Tratamento
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